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NCR hospitals ‘at critical level’ even as infection rate declines

The Department of Health said Tuesday that intensive care unit (ICU) beds in 14 out of 21 hospitals in Metro Manila was at a "critical" level or "almost 100 percent.”

A large tarpaulin hangs outside the emergency room entrance of the Far Eastern University-NRMF Hospital in Quezon City, telling visitors it is already at full capacity from coronavirus cases with the overwhelming number of patients seeking treatment on Tuesday. Manny Palmero
This, as Metro Manila's quarantine level may be eased to a modified enhanced community quarantine (MECQ) by next week as the virus reproduction rate in the National Capital Region is slowing down, the OCTA Research Group said Tuesday.

Malacañang earlier said it was considering placing Metro Manila under MECQ after two weeks of ECQ, the highest in a four-step level.

The capital region's current COVID-19 reproduction number, or the number of people infected by a virus patient, has decreased to 1.53 as of Monday, said OCTA Research fellow Guido David, adding it was expected to slow down to 1.2 after 2 weeks of ECQ.

Officials may reevaluate by the end of the week on whether to extend strict lockdown in the capital region and nearby provinces Bulacan, Cavite, Laguna, and Rizal, David also said.

"Of course, if the reproduction number doesn't decrease, it will be difficult for us...So far, it seems we can make it to 1.2, or even 1.1 but the latter is too optimistic,” he said.

It is expected to reach 1 million cases by the end of the month, OCTA earlier said.

The figure went down from 1.88 percent tallied before the reimposition of enhanced community quarantine, OCTA said.

Researchers reported a 10-percent growth rate in the average number of new COVID-19 cases reported per day in the past week.

“Previous one week growth rates in the NCR were as high as 70 percent,” OCTA said.

Despite the dip in reproduction rate and the negative growth rate in some cities, OCTA said the utilization rate of hospital and intensive care unit beds in NCR remained high.

All LGUs have greater than 60 percent hospital bed occupancy except for Mandaluyong and Parañaque.

Meanwhile, ICU utilization for COVID-19 patients in Metro Manila LGUs is greater than 70 percent, except for Caloocan, Parañaque, and Marikina.

DOH spokesperson Undersecretary Maria Rosario Vergeire said isolation beds at hospitals in the National Capital Region is at "almost 80 percent."

"'High level hospitals are nearing 100 percent capacity. But Level 1 hospitals still have beds that can accommodate patients,” Vergeire told ABS-CBN's Teleradyo, but stopped short of naming the hospitals.

She said that moderate, severe, and critical cases should be hospitalized while mild and asymptomatic patients should be referred to isolation facilities.

Home quarantine is possible, but patients must consult a doctor first via telemedicine, said Vergeire.

"The ideal setup would be a quarantine facility, (for) which we are adding more beds in Metro Manila,” she said.

Virus cases are expected to rise as the agency will apply rapid antigen tests in communities with a high rate of COVID-19 transmission, Vergeire said.

"The number of cases is expected to rise as our testing would be faster and we can identify more positive cases,” she said.

The saliva test should be covered by state insurer PhilHealth as it is also the same process as gold standard RT-PCR, Vergeire said.

"RT-PCR test must be covered by PhilHealth. The specimen is the only thing that changed, saliva and not a nasal or oral swab,” said Vergeire.

Duterte's directive

President Rodrigo Duterte has directed the Philippine Health Insurance Corp. (PhilHealth) to cover those confined in hospital tents amid the rise in new COVID-19 cases under health insurance coverage, Malacanang said.

Presidential spokesperson Harry Roque said the Chief Executive ordered PhilHealth President Dante Gierran to include insurance coverage for patients admitted in hospital tents.

“The order also includes to cover the cost of Reverse Transcription – Polymerase Chain Reaction (RT-PCR) or swab tests and isolation of both mild and critical COVID-19 patients,” Roque said in a televised briefing Tuesday.

Duterte’s directive was triggered by a member of the House of Representatives that some hospitals were charging COVID-19 patients staying in temporary tents P1,000 per hour while awaiting admission since the cost is not covered by PhilHealth. Isolation beds

Public Works and Highways Secretary and Isolation Czar Mark Villar said there were enough COVID-19 isolation beds nationwide, although occupancy of beds in quarantine facilities in the National Capital Region was now at 64.48 percent with the increasing COVID-19 cases in the region.

“To date, only 19,877 beds from our 131,517 total available isolation beds of existing Temporary Treatment and Monitoring Facilities nationwide are utilized,” Villar said.

“From this data, a total of 3,708 beds from the 5,751 beds are occupied in Metro Manila. This is the reason why we are doing our best to fast-track remaining ongoing quarantine facilities, especially within the NCR bubble,” the DPWH chief said.

Among the Mega Temporary Treatment and Monitoring Facilities with high recorded number of bed occupancy rates for COVID-19 infected patients are the PICC Quarantine Facility with 223 out of 263 total beds; Ultra Stadium with 95 of 132 beds occupied; and Filinvest Tent with 74 of 108 beds.

He said the DPWH is now ramping up works on additional treatment facilities in Metro Manila.

‘Critical stage’

Hospital occupancy may remain at critical levels until the end of the week despite the continued implementation of the enhanced community quarantine (ECQ) in the NCR Plus bubble, the OCTA Research Group said Monday.

Dr. Butch Ong, of OCTA, during the Laging Handa public briefing, said the number of COVID-19 cases admitted in hospitals was expected to improve in a week or two.

“We're expecting to see an improvement of the number of cases found in the hospital maybe in a week or two…Right now, I don't see the hospital utilization being eased a bit,” Ong said.

“We can still expect that the hospitals will be in a critical stage perhaps in the middle of the week until the end of this week,” he added.

Due to the surge in COVID-19 cases, the national government placed Metro Manila, Bulacan, Cavite, Laguna, and Rizal or NCR Plus under ECQ from March 29 to April 4 with a new set of regulations. Verge of collapse

The Alliance of Health Workers and the Filipino Nurses United have warned that the health care system was on the verge of collapse amid the surge in COVID-19 cases. The Philippine Hospital Association, on the other hand, said hospitals had been overwhelmed and overrun amid the surge of cases mainly due to their depleted and overworked manpower.

But Health Undersecretary Leopoldo Vega denied the health system was losing the battle vs. COVID-19.

"The health system is not collapsing. It's just that we are trying to manage the challenge of the surge," said Vega, who is also the country's treatment czar. Physical expansion

Meanwhile, deploying tents to expand the health care capacity of hospitals will not be enough to address the COVID-19 surge as there is not enough medical staff to treat patients, a hospital association said Monday.

Private Hospitals Association of the Philippines, Inc. President Dr. Jose de Grano, in an interview on Balitanghali, said that private hospitals in Metro Manila, Central Luzon, and Calabarzon were at full capacity.

"There are still no tents for hospitals in the provinces,” De Grano said.

"It is a bit difficult because even if we expand, we have a problem with who will treat the patients,” he said.

Private hospitals had problems taking care of patients who are still waiting at emergency rooms amid the full capacity at hospitals.

Makeshift hospitals

In related developments, Senator Risa Hontiveros has urged the Inter-Agency Task Force for the Management of Emerging Infectious Diseases and the Department of Health to release a public report on the P9 billion allocated for makeshift hospitals and isolation facilities after hospitals became overwhelmed amid the COVID-19 surge in cases.

The P9 billion, she said, if effectively used, was supposed to go to setting up temporary but humane and fully equipped makeshift hospitals.

"Filipinos shouldn’t have to watch their loved ones die, sometimes under the heat of the sun, just because hospitals are full,” she said.

Hontiveros said the P9 billion budget under Bayanihan 2 dedicated for Temporary Treatment and Monitoring Facilities and isolation facilities needs to be flagged as ‘urgent expenditure’ while hospitals overflow. Sufficient supply

The Department of Health gave assurances Tuesday supplies of Personal Protective Equipment (PPEs) in the country are enough and that distribution of PPEs across health facilities in the country would continue.

Amid the observed increase in cases and the need for distribution of supplemental PPEs in health facilities, the DOH, from March 18-31, has distributed more than 190,000 supplemental PPE supplies to thirteen government hospitals in the National Capital Region, and more than half a million supplies distributed to eight Centers for Health Development across the country.

The DOH is also currently prioritizing the delivery of PPE supplies to hospitals and CHDs in high and critical-risk areas to immediately replenish their stocks and provide constant protection of healthcare workers from the viral transmission.

In CHD-NCR alone, 7,000 sets of 210,000 assorted PPEs, N95 masks and heavy-duty gloves were pulled out and distributed on March 23, 2021.

On the other hand, 114,000 sets of PPEs have been partially delivered to CHDs in Regions I, II, III, IV-A, and Cordillera Administrative Region, and 190,000 sets have been distributed to CHDs in Regions IV-B and V.

Topics: OCTA Research Group , Department of Health , modified enhanced community quarantine , National Capital Region , Guido David , Maria Rosario Vergeire
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